Introduction
Based on advances in mind-body research and the practicality of self-kindness and mindfulness, self-compassion offers a new way of thinking about the practical strategies for ending chronic pain. Self-compassion includes a stance of compassion, friendliness, interest, and open-heartedness toward an experience observed in the present moment. The management of chronic pain today incorporates both physical and psychological interventions because of the significance of self-compassion which relates to aspects such as acceptance of chronic pain, focus on individual strength, and lower levels of negative perception of the pain experience. A study in which an experimental vignette was used investigating the influence of self-compassion on cognitive and behavioral responses to unpleasant events in a chronic pain population found out that higher levels of self-compassion for patients under chronic pain is associated with lower negative effects of sadness and anxiety and higher levels of satisfaction with their social participation (Purdie, 2014). In their responses, 62 participants who participated in the study indicated an above average score in relating self-compassion to increased social connectedness and positive responses to difficult chronic pain situations. In the practical sense, self-compassion helps individuals under pain to avoid negative emotional aspects such as anxiety and contend with their current situation objectively.
Chronic Pain and Negative Emotional Factors
Chronic pain is multidimensional and adversely affects the lives of people. The pain is usually related to an injury that is expected to worsen and may persist for months. Hooten et al. (2013) describe chronic pain as an unpleasant sensory associated with tissue damage and emotional experience based on both physical symptoms and psychological issues. Individuals with chronic pain may manage to carry on with other aspects of their lives but to some, it is difficult to cope with the unpleasant experience and thus they turn to their physicians. The physical discomfort often gets into the mind of the individual and thus negative emotions associated with depression and anxiety often crop up. Chronic pain and the discomforting experience can interfere with an individual’s sleep, energy, and the ability to participate in normal activities. This makes the individual feel worthless and, consequently becomes depressed. Under physical limitations and depression, an individual experiencing chronic pain leads to excessive worrying. Considering the association between chronic pain and depression as well as anxiety, it is practical to conclude that pain and negative emotions are concomitant. Evidence in support of this conclusion comes from studies that involved 110 women with fibromyalgia and osteoarthritis that underwent interpersonal stress interviews and were assessed based on the Center for Epidemiologic Studies Depression Scale for their depression levels and neutral mood indication. Drawing from the questionnaires and data collected from the women, results from the study indicated that the depressed and non-depressed women with a neutral mood reported mean pain rating of over 45% each compared to depressed and non-depressed group with a positive mood who reported mean pain rating of below 35% each (Davis, Thummala, & Zautra, 2014). The study findings lead to the conclusion that changes in mood correlate with increased reports of pain as well as the clinical observations in which depressed patients tend to interpret the subjective experience of pain negatively. In the study, depressed women only recovered when they exhibited a positive mood condition. With negative emotions in the picture, it is essential to consider psychological approaches to reduce the emotional suffering that is linked with the discomforting and limiting pain experience.
Patients experiencing chronic pain often rely on analgesic drugs and painkillers. Despite the fact that many patients consider the use of such drugs, studies aimed at showing the effectiveness of the drugs have focused on the short-term pain relief aspects. According to Chou et al. (2014), painkillers and analgesic drugs are ineffective for long-term use in pain management and are also addictive and have potentially damaging side effects. The report findings necessitate a better approach towards chronic pain management, considering that drugs are ineffective and addictive in the long run and the negative emotions are also evident in patients with chronic pain. From this understanding, most treatment centers have focused on multidimensional treatment approaches that include the physical and psychological domains. However, self-criticism, which is characteristic of individuals with physical limitations and emotional breakdowns is often a limiting factor in relation to the effectiveness of the multidimensional treatment.
Self-criticism is a serious vulnerability factor in relation to the interpersonal relationship with the physicians. Under chronic pain, the physical limitations and emotional breakdowns may lead to self-criticism in which a person becomes pessimistic and shies away from doing things that they really want to do like seek medical attention. Self-criticism has adverse effects on therapeutic alliance and negatively affects social relationships outside treatment which may be a predictor of chronic pain symptom aggravation. According to a review on the theoretical assumptions of psychodynamic treatment and its effectiveness in borderline personality disorder treatment in the treatment of depression in comparison to using pharmacotherapy alone, Luyten and Blatt (2012) present a finding that highlights PT as having better long-term outcomes. The review also points out patients with elevated self-criticism at the pretreatment stage as being less likely to exhibit symptomatic improvement. This is because being pessimistic about self and focusing on limitations limit individual autonomous motivation. In that case, it becomes difficult for individuals under pain to open up with the physicians when undergoing physical treatment. This can only serve to worsen the situation because the individual is haunted by harsh and punitive inner dialogues. In addition, when one cannot find the motivation to open up about certain limitations, it leads their social environment to become filled with risks and negative life events thus social support and other social protective factors lack.
Self-Compassion and Chronic Pain Relief
The main challenge that comes with chronic pain is that the body and the mind are put under stress most of the day when one considers the limitations that come with the pain experience. Individuals apply the majority of their mental and emotional efforts to ward pain off and grasp the pleasures that practically increase depression and anxiety levels. For example, an individual with chronic pain will often feel less capable and limited when trying to join friends in performing certain physical activities. This may increase their stress levels, particularly when the individual insists on engaging in activities that physically strain them thus worsening the physical conditions related to the chronic pain.
According to Luyten and Blatt (2012), an important part of the patient-physician relationship in the management of chronic pain is the optimism/pessimism factor. When an individual with chronic pain is pessimistic because of the physical limitations, it becomes difficult for them to open up for social or medical help and this can only serve to heighten the symptoms of pain. Self-compassion is based on optimism focusing on what can and cannot be done under the pain experience from an objective perspective. Optimistic individuals will most likely seek help from physicians and other social support aspects rather than shy away from presenting their limitations. This can not only help physicians in terms of diagnosis but will also provide social support and help the individual focus on positive life outcomes.
Conclusion
It is essential for individuals not to subject themselves to negative thoughts that increase depression and anxiety or worsens the physical cause of chronic pain. For this reason, self-compassion is an essential part of chronic pain management multidimensional treatment approach (Purdie, 2014). In summary, when an individual experiences the physical limitations and unpleasant feelings associated with chronic pain, being gentle to self makes them more likely to reach out for help, connect, and experience empathy. This is because self-kindness means to stop constant self-criticism and being mindful and accepting the present circumstances. This means individuals will not put themselves under pressure thus aggravating physical and emotional symptoms of the pain but will rather seek social support and medical interventions that can help in managing the pain and cultivating more positive outcomes.
References
Chou, R., Deyo, R., Devine, B., Hansen, R., Sullivan, S., Jarvik, J. G.,Turner, J. (2014). The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain: Evidence Report/technology Assessment, Number 218. Rockville, MD: Agency for Health Care Policy and Research.
Davis, M. C., Thummala, K., & Zautra, A. J. (2014). Stress-related clinical pain and mood in women with chronic pain: Moderating effects of depression and positive mood induction. Annals of Behavioral Medicine, 48(1), 61-70.
Hooten, W. M., Timming, R., Belgrade, M., Gaul, J., Goertz, M., Haake, B.,Schweim, K. (2013). Health Care Guideline: Assessment and Management of Chronic Pain (6th ed.). Bloomington, MN: Institute for Clinical Systems Improvement.
Luyten, P., & Blatt, S. J. (2012). Psychodynamic Treatment of Depression. Psychiatric Clinics of North America, 35(1), 111-129.
Purdie, F. J. (2014). Self‐Compassion, Social Functioning and Chronic Pain (Doctoral dissertation). University of Leeds.
